How geriatric experts care for their own

Gail Joy

Chris Walker/Chicago Tribune

Gail Joy, 77, and her daughter Robin Joy, of San Francisco, on moving day at the family home in Evanston. The elder Joy moved to a continuing care facility a short distance away. "It’s not for everyone, but it was the right decision for me,” Gail Joy says.

Gail Joy, 77, and her daughter Robin Joy, of San Francisco, on moving day at the family home in Evanston. The elder Joy moved to a continuing care facility a short distance away. "It’s not for everyone, but it was the right decision for me,” Gail Joy says. (Chris Walker/Chicago Tribune)

Some 10 million American caregivers are juggling jobs along with households -- and looking after an aging relative was ranked as the No. 1 source of stress, according to a recent survey by Caring.com.

As the ranks of the elderly grow at a record pace, long-term care is the dilemma of our times: how to keep loved ones safe and nurtured, while preserving as much of their independence as possible before the money runs out.

Experts who work in the geriatrics field agree that finances, diagnoses and family dynamics all play big roles in any living arrangement but say there is no one-size-fits-all solution.

Here's how professional and personal lives blurred for three experts -- and the three strategies they used to care for their own.

Gail Joy, 77, raised two children and managed a four-bedroom house in Evanston, where she lived for more than 30 years, the last decade as a widow. She was active, serving on Northwestern University's alumni board and volunteering at her church.

But in 2010, things changed. Joy fell, breaking a few ribs; her daughter, Robin, was in San Francisco, 2,000 miles away."I jumped on an airplane, and while I knew that her injuries weren't life-threatening, I was very worried," said Robin Joy, the vice president of marketing for Caring.com, a popular website for family caregivers.

During the last year, she jumped on a plane five more times, realizing that it was time for her mother to move. Together, they discussed moving to the Bay Area, but Gail Joy rejected this idea as too far from her son and grandchildren, who live in Cincinnati. Besides, she really didn't want to leave Evanston.

So, they opted for a continuing care retirement community -- where residents can get meals, housekeeping and social interaction, then, as abilities decline, move up to assisted living and nursing home units.

Robin Joy is quick to say that she's luckier than many adult children because her mother was on board and it was a topic they had talked about before they were in crisis. Still, the prospect of relocating can be overwhelming for older folks. To remove roadblocks, she hired a professional organizer, devoting three hours a week for a year to help sort through decades of her mom's papers.

Gail Joy moved to Westminster Place in Evanston in May, calling the transition "as smooth as could be."

Two months later, she is enjoying her two-bedroom apartment, surrounded by familiar furnishings, photos and friends. She even discovered two high school classmates across the hall.

Aside from the fact that her home is still on the market, the elder Joy couldn't think of anything she would do differently.

"As you get older, change is inevitable and it's not going to get easier. So if you're thinking about it, go for it. It's not for everyone, but it was the right decision for me."

Cindi Starek: Moving in

Cindi Starek, 46, did not think she would move her grandmother into her Frankfort home. She certainly never envisioned that she would convert her dining room into hospice care, where a hospital bed replaced the table. Or that her husband and 13-year-old son would be so intimately involved in caregiving.

She was simply reacting to the situation.

In late 2008, Starek's trip to Tampa, Fla., to visit Geraldine Woodrick revealed that something was wrong. The evidence kept mounting until the family got a diagnosis: dementia.Within days, Starek had packed up the residence, bringing her grandmother back to the south suburbs, where the octogenarian could move in with Starek's parents.

But a few months later, the family got a one-two punch: Starek's mother needed knee-replacement surgery and Woodrick contracted an infection, requiring hospitalization. After her discharge, the older woman went to a nursing home, ostensibly for rehabilitation. Instead, she went into a free fall, losing weight and sleeping constantly.

"She was in far worse shape than when she entered," said Starek, a nurse, who is also a home care director for Addus Healthcare.

Starek posted a sign, imploring staff to give her grandmother water daily, put her teeth in so she could eat and keep her clean. The situation would improve temporarily before dropping off again.

"Finally, I decided to be part of the solution. I knew we could do better," Starek said.

In June 2009, she moved Grandma home. A niece stayed eight hours a day to provide personal care, the cost split between Medicare and the family. Starek's son, Trevor, watched Woodrick until his mom came home. In the evening, husband John would push her to walk, cheering each tiny step.

The relentless cycle of overworked days, sleepless nights and no weekends is hard to comprehend.

"If you don't have people to help you, it's very difficult. I am in this field and I do have people and I was mentally exhausted from trying to hold it all together. No one could do this alone," Starek said.

On March 3, Woodrick celebrated her 85th birthday at Hooters, wearing a tiara and surrounded by relatives. She died a week later.

"For the last year, it was all about quality of life," Starek said, voice cracking. "We did everything we could do to see that she lived life to the fullest."

Joseph Ozarowski: Staying put

For many aging parents, remaining at home is the ideal. That's what Rabbi Joseph Ozarowski, of Skokie, wanted for his father -- and the son had a more compelling reason than most to carry out his father's wishes.

Oscar Ozarowski, a Holocaust survivor, spent much of his younger life being uprooted, first, from his home in Poland, then to Auschwitz, where he saw his mother and sister herded into gas chambers. After World War II, he spent several years in a displaced-persons camp, before emigrating to Canada and then settling in St. Louis.

"He said he wanted to die in his own bed," said his son, "with the dignity that the Nazis denied him."

In March 2010, the 96-year-old died on his terms, after a long battle with congestive heart failure.

"Sometimes, God really does answer our prayers," said Joseph Ozarowski, a chaplain with the Jewish Healing Network of Chicago, which supports people coping with illness and loss.

But pulling it off couldn't have happened without a deep commitment. Starting in 2008, Ozarowski and his sister, who lives near Washington, alternated most weekends shuttling between their homes and St. Louis.Even with assistance, most of the work fell to their mother, he said.

"She is incredibly devoted and resilient. If she hadn't been there, I don't know what we would have done," he said. "Neither of us were able to move to St. Louis which is why I don't judge people who are faced with some very tough decisions."

But none of it was easy. The children worried whether they were doing enough, about the effect their father's health was having on their mother. The 10-hour round-trip commute was grinding them down, and it often meant forgoing their children's activities to be with their father.

And despite everyone's best efforts, there's no guarantee of a perfect ending. When his father slipped away, Ozarowski was on the interstate, just a couple of hours away.

Join us at noon CT on Tuesday, January 11, to chat about caregiving. It takes time, energy and preparation to be a good caregiver. A caregiver has to keep track of medical tests and doctors' visits, deal with bills and health insurance, and make sure family members communicate with each other....